My friend's ongoing saga - now onto a Phase 1 trial Xofigo + Atezolizumab

My friend has mCRPC; I've posted here about him before.

He has run through Zytiga, Xtandi, TRANSFORMER trial (BAT testosterone therapy), and is still progressing.

He's now embarked on a Phase 1 clinical trial, combining Atezolizumab with Xofigo. The Atezolizumab is for the soft tissue mets, with Xofigo for the bone mets. Here's a link to the description:
Safety and Tolerability of Atezolizumab (ATZ) in Combination With Radium-223 Dichloride (R-223-D) in Metastatic Castrate-Resistant Prostate Cancer (CRPC) Progressed Following Treatment With an Androgen Pathway Inhibitor

So far they're assessing toxicity with the combo. From the description:
"This study is designed to assess the safety and tolerability of atezolizumab when given in combination with radium-223 dichloride in participants with metastatic CRPC who have progressed after treatment with an androgen pathway inhibitor. This adaptive design study includes a cohort phase and a potential randomization phase. An initial concurrent dosing evaluation will evaluate the safety and tolerability of a treatment regimen that employs a concurrent start time for atezolizumab and radium-223 dichloride (Cohort 1). "

I think he's on this initial cohort phase, so it is about as experimental as it gets. I'm not sure he quite realizes what's involved with this kind of test. However, his PSA is running away, with many identified mets, bony and soft tissue. So, it kind of is time for a hail Mary. We owe a lot to guys who embark on these experimental trials! Here's hoping for some benefit to him.

Does anyone else here know of someone on this trial? He's doing it here at Univ of Michigan.

Thanks, Allen. I hadn't considered the abscopal effect, but with the radioactive agent Xofigo that does make sense.

I'll probably see him today at our support group, so I'll pass that aspect along to him.

Update -

Well, my friend has taken a severe turn for the worse. He is in ICU on life support...

He collapsed at home, seized in the ambulance transport, and is on a ventilator in ICU. It seems he has brain inflammation, and they're speculating that it may be due to complications from the Atezolizumab. The theory is that excessive antibody reaction may have caused the inflammation, so they are doing blood plasma changes (somehow?) to clear that to a lower level. (That's second hand info, so perhaps it's not very accurate, but it's as much as we have heard). Maybe due to the combination with Xofigo? Unknown, but that's the reason for the Phase 1 trials of things like this.

There is hope that his brain swelling will reduce and he can function on his own again, but the situation is frankly quite dire. His wife is terribly distraught. We're just hoping he actually gets to go home again...

We owe so much to our brave compatriots who participate in these Phase 1 trials. There can be unforeseen risks, yet without these trials we would not have many of the treatments we now take for granted.

Redwing57 said...
Update -

We owe so much to our brave compatriots who participate in these Phase 1 trials. There can be unforeseen risks, yet without these trials we would not have many of the treatments we now take for granted.

.... totally agree. Someone has to go over the wall first before victory can be secured.